NUR250 Mental Health &

Gerontology Nursing
Anti Parkinsonism Drug
 Antiparkinsonism drug
• Definition
 Antiparkinson drugs are medicines that relieve the symptoms
of Parkinson's disease and other forms of parkinsonism.

• Indication
 Antiparkinson drugs are used to treat symptoms of
parkinsonism, a group of disorders that share four main
symptoms: tremor or trembling in the hands, arms, legs, jaw,
and face; stiffness or rigidity of the arms, legs, and trunk;
slowness of movement (bradykinesia); and poor balance and
coordination.
• Side effect

o The most common side effects are associated

with the central nervous system, and include
dizziness, lightheadedness, mood changes and
hallucinations. Gastrointestinal problems,
including nausea and vomiting, are also
common.
 Examples

A. Rapinirole ( Requip )
B. Pergolide ( Permax )
C. Levodopa (Laradopa )
 A. Ropinirole (Requip )
• Indication
 This medication is used alone or with other medications to
treat Parkinson's disease. It can improve your ability to move
and decrease shakiness (tremor), stiffness, slowed
movement, and unsteadiness. It may also decrease the
number of episodes of not being able to move ("on-off
syndrome").
 Ropinirole is also used to treat restless legs syndrome (RLS). It
may improve your sleep by decreasing the urge to move your
legs and decreasing uncomfortable/unpleasant feelings in the
legs.
 This medication works by helping to restore the balance of a
certain natural substance (dopamine) in the brain.
 Nursing Management
• If the client is taking this medication for
Parkinson's disease, take this medication by mouth
with or without food, usually 3 times a day as
directed by doctor.
• Taking this medication with food may reduce
nausea.
• To decrease the risk of side effects (e.g., drowsiness,
low blood pressure) when the client first start
taking ropinirole, doctor will slowly increase their
dosage until the best dose for them to reach.
• If the clients are using this medication for RLS,
take this medication by mouth, usually once daily
with or without food, 1-3 hours before bedtime or
as directed by doctor.
• Use this medication regularly in order to get the
most benefit from it .
• Do not stop taking this medication without doctor's
approval.
• If the client suddenly stop taking this drug,
withdrawal reactions may occur. Such reactions can
include fever, muscle stiffness and confusion.
• Report any such reactions to your doctor
immediately.
• Many people using this medication do not
have serious side effects.Tell the doctor
immediately if any of these unlikely but
serious side effects occur.
• Do not drive, use machinery, or do any activity
that requires alertness until you are sure you
can perform such activities safely .
• Before taking ropinirole, tell your doctor or
pharmacist if you are allergic to it; or if you
have any other allergies
 B. Pergolide (Permax)
Before taking pergolide, tell your doctor if you have :

• lung or breathing problems such as inflammation of the

lining of the lungs (pleuritis), fluid in the lungs (pleural
effusion), or scar tissue in the lungs (pleural fibrosis);
• heart problems such as inflammation of the lining of the
heart (pericarditis), fluid around the heart (pericardial
effusion), heart valve problems, or irregular heartbeats;
• retroperitoneal fibrosis (a chronic inflammatory
disease); or
• kidney or liver disease.
• Take pergolide exactly as directed by your
doctor. If you do not understand these
directions, ask your pharmacist, nurse, or
doctor to explain them to you.
• Take each dose with a full glass of water.
• It is important to take pergolide regularly to
get the most benefit.
• Do not stop taking pergolide without first talking
to your doctor. Stopping pergolide suddenly may
cause potentially dangerous side effects such as
elevated body temperature, muscle rigidity,
confusion or altered consciousness, and other
problems.
 C. Levodopa (Laradopa )
• Do not take levodopa if you have taken a
monoamine oxidase inhibitor (MAOI), such as
isocarboxazid (Marplan), tranylcypromine (Parnate),
or phenelzine (Nardil) withinin the past 2 weeks.
• Do not take levodopa without first talking to your
doctor if you have
o narrow-angle glaucoma (angle closure glaucoma), or
o malignant melanoma (a type of skin cancer).
• Before taking this medication, tell your doctor if you
have
o any kind of heart disease, including high blood pressure
, arteriosclerosis, hardening of the arteries, a previous
heart attack, or an irregular heartbeat;
o respiratory disease, including asthma and
chronic obstructive pulmonary disease (COPD);
o liver disease;
o kidney disease;
o an endocrine (hormonal) disease;
o a stomach or intestinal ulcer;
o wide-angle glaucoma; or
o depression or any other psychiatric disorder.
• Avoid vitamin products that contain vitamin
B6 (pyridoxine). This vitamin may reduce the
effectiveness of levodopa.
• Talk to your doctor and pharmacist before
taking any prescription or over-the-counter
medicines, including vitamins, minerals, and
herbal products.